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Claim Configuration Analyst Jobs in Reston, VA (NOW HIRING)

Lucyrx

Account Coordinator

Bethesda, MD · On-site +1

$21.50 - $27.75/hr

Research and support claim/configuration inquiries; document findings and coordinate resources to ... Analytical and detail-oriented; able to support QA/testing and identify discrepancies. * Proficient ...

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All JobsClaim Configuration Analyst JobsClaim Configuration Analyst Jobs in Reston, VA

Claim Configuration Analyst information

See Reston, VA salary details

$15

$42

$71

How much do claim configuration analyst jobs pay per hour?

As of Jun 23, 2026, the average hourly pay for claim configuration analyst in Reston, VA is $42.98, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $55.00 per hour, depending on experience, location, and employer.

What are Claim Configuration Analysts?

Claim Configuration Analysts are professionals who specialize in setting up and maintaining the rules, processes, and systems that handle insurance claims within an organization. They ensure that claim processing systems are configured accurately to follow policy guidelines, regulatory requirements, and company procedures. Their role often involves analyzing data, troubleshooting issues, and collaborating with IT, claims, and business teams to optimize claim workflows. By ensuring correct system configurations, they help reduce errors, improve operational efficiency, and support timely claim resolutions.

What is the difference between Claim Configuration Analyst vs Claims Processor?

AspectClaim Configuration AnalystClaims Processor
Primary ResponsibilitiesDesigns and manages claim system setups, analyzes configuration issues, and optimizes claim workflows.Processes individual claims, verifies information, and ensures accurate claim adjudication.
Required Skills & CertificationsKnowledge of insurance systems, data analysis, and possibly certifications like CPCU or similar.Attention to detail, familiarity with claims software, and basic insurance knowledge.
Work EnvironmentTypically office-based, working with IT teams and claims systems.Office or remote, handling claims directly or via claims processing platforms.

The Claim Configuration Analyst focuses on configuring and optimizing claim systems and workflows, while the Claims Processor handles the day-to-day processing of individual claims. Both roles require insurance knowledge, but the analyst role emphasizes system setup and analysis, whereas the processor role emphasizes claim review and verification.

What does a configuration analyst do?

A claim configuration analyst is responsible for setting up and maintaining claim processing systems, ensuring accurate claim adjudication and compliance with policies. They analyze system configurations, troubleshoot issues, and may use tools like claim management software to optimize workflows and reduce errors.

What are the key skills and qualifications needed to thrive as a Claim Configuration Analyst, and why are they important?

To thrive as a Claim Configuration Analyst, you need a strong understanding of healthcare claims processing, benefits administration, and analytical problem-solving, often supported by a degree in business, information systems, or a related field. Familiarity with claims adjudication systems (such as Facets or QNXT), SQL, and potentially industry certifications like Certified Claims Professional (CCP) are commonly required. Attention to detail, effective communication, and the ability to work collaboratively with cross-functional teams are crucial soft skills. These competencies ensure accurate claim system configuration, regulatory compliance, and efficient operations within health insurance organizations.

What does a claims analyst do?

A claims analyst reviews and processes insurance claims to ensure accuracy and compliance with policies. They investigate claim details, verify documentation, and determine claim validity, often using specialized software and data analysis skills. Their work helps ensure timely and fair claim settlements for clients and insurers.

What are some common challenges faced by Claim Configuration Analysts, and how can they be addressed?

Claim Configuration Analysts often encounter challenges such as interpreting complex insurance policies, ensuring accurate system configuration to minimize claim errors, and keeping up with frequent regulatory changes. Addressing these challenges requires strong analytical skills, attention to detail, and effective collaboration with cross-functional teams like IT, compliance, and claims processing. Regular training and open communication channels help analysts stay updated and maintain high-quality configurations, ultimately reducing errors and improving efficiency.

What jobs pay 500,000 a year in the US?

Claim Configuration Analysts typically do not earn $500,000 annually; such high salaries are usually associated with executive roles, specialized surgeons, or successful entrepreneurs. High-paying jobs often require advanced skills, extensive experience, or ownership of a business. Compensation at this level is rare in standard analyst positions and more common in executive or highly specialized fields.

What jobs pay 2000 a day?

Claim Configuration Analysts typically do not earn $2000 a day; such high daily rates are more common in specialized consulting, executive roles, or highly paid freelance positions. Most standard roles in claims analysis offer annual salaries rather than daily rates, but freelance or contract work in related fields can sometimes reach that level with extensive experience and expertise. Earning $2000 a day generally requires advanced skills, certifications, or senior-level responsibilities in high-demand industries.
What are popular job titles related to Claim Configuration Analyst jobs in Reston, VA? For Claim Configuration Analyst jobs in Reston, VA, the most frequently searched job titles are:
What job categories do people searching Claim Configuration Analyst jobs in Reston, VA look for? The top searched job categories for Claim Configuration Analyst jobs in Reston, VA are:
What cities near Reston, VA are hiring for Claim Configuration Analyst jobs? Cities near Reston, VA with the most Claim Configuration Analyst job openings:
Claim Configuration Analyst jobs near you

Account Coordinator

Lucyrx

Bethesda, MD • On-site, Remote

$21.50 - $27.75/hr

Full-time

Medical

Posted 4 days ago

Job description

It's fun to work in a company where people truly BELIEVE in what they're doing!

We're committed to bringing passion and customer focus to the business.

The Account Coordinator supports the PBM Commercial Account Management team serving large commercial clients by coordinating day-to-day client support and helping ensure timely, accurate service delivery. In partnership with Account Managers and internal teams, this role tracks requests through resolution, supports benefit/eligibility and configuration-related inquiries, assists with reporting and client deliverables (including RFP/RFI responses), and helps perform QA/testing to validate updates and identify discrepancies. The Account Coordinator maintains accurate documentation and CRM records, supports client meetings and follow-ups, and contributes to continuous process improvement.

This positionwillbebasedremotely,unlessotherwisedirectedbythe Company.Youshouldexpecttotravelforteammeetings,clientmeetingsorothercollaborationneeds.

Role And Responsibilities

  • Support routine client inquiries and requests, including prior authorization entry, benefit/eligibility changes, configuration inquiries, claims reviews, ad hoc reporting, and QA/testing support.
  • Track client requests, issues, and deliverables; follow up with internal departments to support timely completion and documentation.
  • Track service issues against SLAs (as applicable), monitor aging/open items, and escalate risks to the Account Manager.
  • Support implementations and ongoing account activities (timelines, benefit requests, plan documentation, and internal coordination).
  • Support RFP/RFI and other client documentation requests by gathering required information, coordinating internal input, and tracking responses and deadlines.
  • Support client meetings by preparing agendas/materials, capturing notes/action items, and tracking follow-ups.
  • Maintain organized client documentation (e.g., plan docs, communications, and deliverables) in shared repositories; ensure version control.
  • Support annual renewals and periodic account updates by coordinating data collection, compiling inputs, and tracking approvals and deadlines.
  • Perform QA/testing (pre- and post-implementation) to validate configuration accuracy and identify discrepancies.
  • Research and support claim/configuration inquiries; document findings and coordinate resources to resolve issues.
  • Support client reporting and presentations; help identify trends and opportunities for improvement.
  • Maintain accurate CRM/tracking records and collaborate cross-functionally to support service delivery and process improvement.

Qualifications And Education Requirements

  • Bachelor's degree or equivalent relevant experience.
  • 1+ years of experience in account support/client services, healthcare administration, PBM/health plan/benefits, or a related field.
  • Strong communication skills and the ability to build effective working relationships.
  • Highly organized with strong attention to detail; ability to manage multiple priorities and deadlines.
  • Analytical and detail-oriented; able to support QA/testing and identify discrepancies.
  • Proficient in Microsoft Office (especially Excel) and experienced with Salesforce (or comparable CRM); able to learn new systems quickly.

Preferences

  • Experience supporting large commercial accounts.
  • PBM/pharmacy benefits, health plan, insurance, or benefits consulting experience.
  • Exposure to claims, eligibility/benefits administration, or configuration/testing workflows.
  • Advanced Excel skills (e.g., pivot tables, lookups) are a plus.
  • Experience using AI tools (e.g., copilots/assistants) to draft summaries, support analysis, or improve workflow efficiency while following data privacy and security requirements.

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

This is a largely sedentary role; however, some standing, walking, bending, and reaching may be required. Regularly operates in an office or home office setting which involves utilizing a computer, mouse, keyboard, and occasionally operates other standard office equipment, such as printer, copier, phone. Travel may be required by either car or airplane, or a combination of multiple modes of transportation.

What We Do


LucyRx is an independent, next-generation pharmacy benefits manager (PBM) transforming how healthcare works. We're fixing what's broken in the PBM industry by putting people first and challenging outdated norms. For too long, traditional PBMs have prioritized profit over patients, and we believe that's just plain wrong.

LucyRx offers bold, innovative solutions powered by LucyIQ, our proprietary AI platform, to deliver actionable insights that lower costs, improve care, and simplify prescription management.

While we're new to the PBM space, LucyRx is built on decades of leadership experience and a commitment to meaningful change. We're a nimble, remote-first team with a bold mission to redefine pharmacy benefits-and we're just getting started.


This positionwillbebasedremotely,unlessotherwisedirectedbythe Company.Youshouldexpecttotravelforteammeetings,clientmeetingsorothercollaborationneeds.

Salary:
$24.56-$28.78 per hour

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